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1.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.23.23298451

ABSTRACT

ABSTRACT Background: There is a paucity of data on the factors associated with severe COVID-19 disease, especially in children. This systematic review and meta-analysis aim to identify the risk factors for acute adverse outcomes of COVID-19 within paediatric populations, using the recruitment setting as a proxy of initial disease severity. Methods: A systematic review and meta-analysis were performed representing published evidence from the start of the pandemic up to 14 February 2022. Our primary outcome was the identification of risk factors for adverse outcomes, stratified by recruitment setting (community, hospital). No geographical restrictions were imposed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the certainty in the body of evidence for each meta-analysis. In anticipation of significant clinical and methodological heterogeneity in the meta-analyses, we fitted logistic regression models with random effects. Findings: Our review identified 47 studies involving 94,210 paediatric cases of COVID-19. Infants up to 3 months were more likely to be hospitalised than older children. Gender and ethnicity were not associated with an increased likelihood of adverse outcomes among children within the community setting. Concerning comorbidities, having at least one pre-existing disease increased the odds of hospitalisation. Concerning BMI, underweight children and severely obese were noted to have an increased likelihood of hospital admission. The presence of metabolic disorders and children with underlying cardiovascular diseases, respiratory disorders, neuromuscular disorders and neurologic conditions were also more likely to be hospitalised. Concerning underlying comorbidities, paediatric hospitalised patients with congenital/genetic disease, those obese, with malignancy, cardiovascular diseases and respiratory disease were associated with higher odds of being admitted to ICU or ventilated. Interpretation: Our findings suggest that age, male, gender, and paediatric comorbidities increased the likelihood of hospital and ICU admission. Obesity, malignancy, and respiratory and cardiovascular disorders were among the most important risk factors for hospital and ICU admission among children with COVID-19. The extent to which these factors were linked to actual severity or where the application of cautious preventive care is an area in which further research is needed.


Subject(s)
Neoplasms , Obesity , Respiratory Insufficiency , Respiratory Tract Diseases , Metabolic Diseases , COVID-19 , Cardiovascular Diseases , Neuromuscular Diseases , Genetic Diseases, Inborn
2.
preprints.org; 2024.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202402.1096.v1

ABSTRACT

We present a case of a 47-year-old male who died unexpectedly from acute pulmonary hemorrhage 555 days after completing the BNT162b2 (Pfizer) COVID-19 vaccination primary series. Before death, he exhibited symptoms of a mild respiratory infection. Despite a healthy medical history and no medication use, the patient’s condition rapidly deteriorated and he experienced severe respiratory distress, followed by cardiopulmonary arrest with evidence of profuse pulmonary bleeding. Autopsy findings revealed massive lung congestion without embolism, normal heart size, moderate coronary atherosclerosis without myocardial infarction, and no evidence of other hemorrhagic events. The patient tested negative for COVID-19 and other respiratory pathogens at autopsy. Despite these findings, the medical examiner determined the cause of death was attributed to atherosclerotic and hypertensive cardiovascular disease, without considering the recent pulmonary hemorrhage and unremarkable medical history. Investigation into the vaccine batch indicated a higher-than-average number of serious adverse events, including fatalities. The patient's BNT162b2 batch was among the top 2.8% for reported deaths. Moreover, the autopsy failed to investigate potential contributions from the vaccine, such as the presence of the Spike protein or related antibodies. The evidence suggests that the pulmonary hemorrhage, exacerbated by a viral infection, was the immediate cause of death, with the COVID-19 vaccine potentially playing a role in the development of cardiopulmonary pathology and hemorrhage. We propose autopsy protocols for COVID-19 vaccine recipients to better investigate vaccine-related pathologies among those with one or more prior injections.


Subject(s)
Respiratory Distress Syndrome , Pulmonary Embolism , Death , Myocardial Infarction , COVID-19 , Cardiovascular Diseases , Respiratory Tract Infections , Atherosclerosis , Embolism , Heart Arrest , Hemorrhage , Coronary Artery Disease
3.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.12.24302698

ABSTRACT

Using longitudinal health records from 45.7 million adults in England followed for a year, our study compared the incidence of thrombotic and cardiovascular complications after first, second and booster doses of brands and combinations of COVID-19 vaccines used during the first two years of the UK vaccination program with the incidence before or without the corresponding vaccination. The incidence of common arterial thrombotic events (mainly acute myocardial infarction and ischaemic stroke) was generally lower after each vaccine dose, brand and combination. Similarly, the incidence of common venous thrombotic events, (mainly pulmonary embolism and lower limb deep venous thrombosis) was lower after vaccination. There was a higher incidence of previously reported rare harms after vaccination: vaccine-induced thrombotic thrombocytopenia after first ChAdOx1 vaccination, and myocarditis and pericarditis after first, second and transiently after booster mRNA vaccination (BNT-162b2 and mRNA- 1273) These findings support the wide uptake of future COVID-19 vaccination programs.


Subject(s)
Myocarditis , Purpura, Thrombotic Thrombocytopenic , Cerebral Infarction , Pulmonary Embolism , Myocardial Infarction , Pericarditis , COVID-19 , Cardiovascular Diseases , Venous Thromboembolism , Venous Thrombosis , Thrombosis
4.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.05.24302369

ABSTRACT

The novel coronavirus (COVID-19) is known to be the fifth pandemic causing massive deaths worldwide. This virus has not only been deeply associated with acute respiratory distress, but also acute kidney injury (AKI). This study describes the baseline characteristics and various outcomes of AKI based on the KDIGO 2012 Clinical Practice Guidelines in patients hospitalized with COVID-19 at a Philippine tertiary hospital. A total of 195 patient records were retrospectively reviewed for the study. Of the 195 patients, 81(42%) patients developed AKI. Significant baseline characteristics included older age (56.28 + 14.12), presence of hypertension (p=0.004), diabetes mellitus (p=0.002), and cardiovascular disease (p=0.003). Also, the use of diuretics, inotropes and antibiotics were more prevalent in patients who developed AKI. Most of the patients who had AKI were categorized as stage 1 (49.38%).  Mechanical ventilation was significantly (p<0.001) more prevalent in patients with AKI (20.99%) compared to patients without AKI (5.26%). There was significantly higher rates (p<0.001) of renal replacement therapy in patients with AKI (30.86%). Lastly, higher mortality rates were observed in patients with AKI (50.62%) versus patients without AKI (12.28%). Our study demonstrated that patients with COVID-19 can develop AKI and tend to have a poorer prognosis.


Subject(s)
Diabetes Mellitus , Kidney Diseases , COVID-19 , Cardiovascular Diseases , Acute Kidney Injury , Hypertension
5.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.02.24301686

ABSTRACT

Dysregulated innate immune responses contribute to multisystem inflammatory syndrome in children (MIS-C), characterized by gastrointestinal, mucocutaneous, and/or cardiovascular injury occurring weeks after SARS-CoV-2 exposure. To investigate innate immune functions in MIS-C, we stimulated ex vivo peripheral blood cells from MIS-C patients with agonists of Toll-like receptors (TLR), key innate immune response initiators. We found severely dampened cytokine responses and elevated gene expression of negative regulators of TLR signaling. Increased plasma levels of zonulin, a gut leakage marker, were also detected. These effects were also observed in children enrolled months after MIS-C recovery. Moreover, cells from MIS-C children carrying rare genetic variants of lysosomal trafficking regulator (LYST) were less refractory to TLR stimulation and exhibited lysosomal and mitochondrial abnormalities with altered energy metabolism. Our results strongly suggest that MIS-C hyperinflammation and/or excessive or prolonged stimulation with gut-originated TLR ligands drive immune cells to a lasting refractory state. TLR hyporesponsiveness is likely beneficial, as suggested by excess lymphopenia among rare LYST variant carriers. Our findings point to cellular mechanisms underlying TLR hyporesponsiveness; identify genetic determinants that may explain the MIS-C clinical spectrum; suggest potential associations between innate refractory states and long COVID; and highlight the need to monitor long-term consequences of MIS-C.


Subject(s)
Cryopyrin-Associated Periodic Syndromes , Cardiovascular Diseases , Protein-Energy Malnutrition , Lymphopenia , Mitochondrial Diseases
6.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.02.24302216

ABSTRACT

Introduction: Among adults who test positive for COVID-19, some develop long COVID (symptoms lasting [≥]3 months), and some do not. We compared 3 groups on selected measures to help determine strategies to reduce COVID impact. Methods: Using Stata and data for 385,617 adults from the 2022 Behavioral Risk Factor Surveillance System, we compared adults reporting long COVID, those with just a positive test, and those who never tested positive, on several health status and risk factor measures plus vaccination rates (data for 178,949 adults in 29 states). Results: Prevalence of just COVID was 26.5% (95% CI 26.2-26.8) and long COVID was 7.4% (7.3-7.6). Compared with adults with just COVID those with long COVID had worse rates for 13 of 17 measures of chronic disease, disability, and poor health status, while those with just COVID had the best results for 15 of the 17 measures among all 3 groups. The 5 risk factors (obesity, diabetes, asthma, cardiovascular disease, and COPD) previously associated with COVID deaths, increased long COVID but not just COVID rates, which were highest among younger and higher income adults. Adults with long COVID had the highest rate among the 3 groups for any COVID risk factors and data from 29 states showed they had the lowest rates for [≥]3 vaccine doses of 35.6%, vs. 42.7% and 50.3% for those with just a positive test, and neither, respectively. Vaccination with [≥]3 vaccines vs. <3 reduced long COVID rates by 38%, and just COVID rates by 16%. Conclusions: Results show the seriousness of long COVID vs. just a positive test and that increasing vaccine coverage by targeting adults with risk factors shows promise for reducing COVID impact.


Subject(s)
Chronic Disease , Diabetes Mellitus , Obesity , COVID-19 , Cardiovascular Diseases , Pulmonary Disease, Chronic Obstructive , Asthma
7.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170667171.10307493.v1

ABSTRACT

This article briefly reviews ocean and seas as huge and novel biomedical resources for anti-infection, which includes tuberculosis, H. Pylori, and HIV infection as well as SARS-CoV-2, and as promising biomedical resources for infection-induced major non-communicable diseases (mNCDs), such as cardiovascular disease, diabetes, and cancer. These marine natural products (MNPs) and organisms include sea cucumbers, sea snake, sponge, marine algae and microalgae, etc. As key biomedical resources for the discovery of marine drugs, bioactive molecules, and agents for treatment of infectious diseases and mNCDs, MNPs have bioactive potentials of antioxidant, anti-infection, anti-inflammatory, anticoagulant, anti-diabetic effects, and cancer treatment. In addition, their anti-inflammatory mechanisms for infectious diseases are also involved. It’s time to protect ocean ecosystem for human better sustainable development in the new era of ocean economy.


Subject(s)
Diabetes Mellitus , Neoplasms , Cardiovascular Diseases , HIV Infections , Communicable Diseases , Tuberculosis
8.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170667182.26466828.v1

ABSTRACT

Lots of meta-analysis emphasize that a great number of hospitalized patients with moderate and severe forms of COVID-19 developed acute myocardial damage, defined as an increase of cardiac biomarkers, such N-terminal pro–B-type natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB) and of all type of troponins. The highest mortality rate is related with progressively increasing biomarkers levels and with a history of cardiovascular disease. In fact, the biomarkers dosage should be considered as a prognostic marker in all patients with COVID-19 disease at admission, during hospitalization and in the case of clinical deterioration. The purpose of this review is to evaluate cardiovascular prognostic factors in COVID-19 disease throughout the analysis of cardiac biomarkers to early identify the most serious patients and to optimize their outcomes.


Subject(s)
Cardiomyopathies , COVID-19 , Cardiovascular Diseases
9.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170668403.32370968.v1

ABSTRACT

Major marine natural products (MNPs) and marine organisms include sea urchin, sea squirts or ascidians, sea cucumbers, sea snake, sponge, soft coral, marine algae, and microalgae. As vital biomedical resources for the discovery of marine drugs, bioactive molecules, and agents for treatment of infectious diseases and major non-communicable diseases (mNCDs), these MNPs have bioactive potentials of antioxidant, anti-infection, anti-inflammatory, anticoagulant, anti-diabetic effects, cancer treatment, and improvement of human immunity. This article reviews MNPs as huge and novel biomedical resources for anti-infection of coronavirus (SARS-CoV-2 and its variants), as well tuberculosis, H. Pylori, and HIV infection, and as promising biomedical resources for SARS-CoV-2 infection related cardiovascular disease (irCVD), and other mNCDs, such as diabetes and cancer. In addition, the anti-inflammatory mechanisms of current MNPs against SARS-CoV-2 infection which link to human immunity are also involved. It’s time to protect this ecosystem for human better sustainable development in the new era of ocean economy.


Subject(s)
Diabetes Mellitus , Neoplasms , Motion Sickness , COVID-19 , Cardiovascular Diseases , HIV Infections , Communicable Diseases , Tuberculosis
10.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170669219.91370250.v1

ABSTRACT

Background: While the coronavirus disease 2019 (COVID-19) is most commonly associated with the respiratory system, disorders in other organ systems, such as the cardiovascular, neurologic, or renal, can also contribute to disease fatality. This study aimed to evaluate the relation of comorbidities to COVID-19 short-term mortality. Method: This was a single-center observational study with a historical cohort method at Bethesda Hospital Yogyakarta, Indonesia. COVID-19 diagnosis was made by utilizing reverse transcriptase-polymerase chain reaction (RT-PCR) on nasopharyngeal swabs. Patient data were retrieved from electronic medical records and used for Charlson Comorbidity Index assessments. In-hospital mortality was monitored throughout their hospital stay. Results: This study enrolled 333 patients. According to the total number of comorbidities in Charlson, 11.7% (n=39) of patients had no comorbidities; 30.9% (n=103) of patients had one comorbidity; 20.1% (n=67) of patients had two comorbidities; and 37.2% (n=124) of patients had more than three comorbidities. In multivariate analysis, these variables were significantly related to short-term mortality in COVID-19 patients: older age (odds ratio [OR] per year 1.64; 95% confidence interval [CI] 1.23-2.19; p 0.001), myocardial infarction (OR 3.57 ; 95% CI 1.49-8.56; p: 0.004), diabetes mellitus (OR 2.41; 95 CI 1.17-4.97; p: 0.017), renal disease (OR 5.18 ; 95% CI 2.07-12.97; p <0.001), and longer duration of stay (OR 1.20; 95% CI 1.08-1.32; p <0.001). Conclusion: Our study revealed multiple risk factors for mortality in patients with COVID-19. The coexistence of cardiovascular disease, diabetes, and renal problem are significant predictors of short-term mortality in COVID-19 patients.


Subject(s)
Diabetes Mellitus , Kidney Diseases , Myocardial Infarction , COVID-19 , Cardiovascular Diseases
11.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170670243.38938793.v1

ABSTRACT

Cardiovascular diseases (CVDs) remain the cause of millions of deaths in the world annually. Despite the great progress in therapies, which are available for patients with CVDs, some limitations including drug complications still exist. Hence, the endocannabinoid system (ECS) was proposed as a new avenue for CVDs treatment. The cardiovascular action of cannabinoids is complex as they not only affect vasculature and myocardium directly via specific receptors but also exert indirect effects through the central and peripheral nervous system. The growing interest in phytocannabinoid studies has been broadened the knowledge about their molecular targets as well as therapeutical properties, nonetheless, some areas of their actions are not yet fully recognized. The purpose of this review is to summarize and update the cardiovascular actions of the most potent phytocannabinoids and the potential therapeutic role of ECS in CVDs, including ischemic reperfusion injury, arrhythmia, heart failure, hypertension as well as cardiac complications associated with the novel coronavirus SARS-CoV-2 infections.


Subject(s)
Ischemia , COVID-19 , Cardiovascular Diseases , Coronavirus Infections , Heart Failure , Arrhythmias, Cardiac , Hypertension
12.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3913399.v1

ABSTRACT

Background: The SARS-CoV-2 Omicron pandemic had a global impact on individuals with cancers. This study aimed to investigate the effect of Omicron infection on cancer patients in China. Methods: A retrospective study was conducted, including 347 patients with cancer who received radiotherapy or chemoradiotherapy between July 2022 and March 2023. The patients were divided into three groups: those without SARS-CoV-2 infection during treatment (Non-COVID-19 group), those who began treatment at least 10 days after first testing positive for SARS-CoV-2 (≥10-d COVID-19 group), and those who began treatment less than 10 days after first testing positive for SARS-CoV-2 (<10-d COVID-19 group). The serum levels of SAA, hsCRP, ALT, etc, were used to assess the severity of inflammation, liver damage, and cardiovascular injury. Results: The proportion of moderate and severe infected cases was higher in ≥10-d COVID-19 group compared with <10-d COVID-19 group (p=0.0446). Additionally, the serum levels of SAA, hsCRP, IL-6 and PCT, were significantly higher in ≥10-d COVID-19 group (p<0.05). Serum ALT, LDH and HBDH levels were also elevated in ≥10-d COVID-19 group (p<0.05). However, no significant differences were observed in frequency of neutropenia, thrombocytopenia and completion rates among three groups. Conclusion: Omicron infection leads to inflammation, liver damage and cardiovascular injury in cancer patients. Surprisingly, the duration of delay in radiotherapy or chemoradiotherapy after Omicron infection did not affect completion rates of current therapy, which was not consistent with the recommendations of NCCN guidelines. Moreover, the severity of Omicron infection was worse among cancer patients who received delayed treatment.


Subject(s)
Neoplasms , Inflammation , Chemical and Drug Induced Liver Injury , Thrombocytopenia , COVID-19 , Cardiovascular Diseases , Neutropenia , Infections
13.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3900486.v1

ABSTRACT

Background In the German emergency medical services, 67 rescue helicopters and 12 helicopters for rescue and intensive care transport missions provide their services mostly under visual flight conditions. Of these, 10 helicopters are equipped with a rescue hoist. There is limited data on the frequency of hoist operations, tracer diagnoses, and influences such as weather and vacation periods. This study examines hoist deployment frequencies, tracer diagnostics, and the influence of vacation season at three German helicopter sites.Methods In the period from 01 Feb. 2018 to 31 Dec. 2021, a total of 1340 hoist missions were retrospectively examined descriptively for the helicopters Christoph 15 (n = 196), Christoph 1 (n = 316), and Christoph Murnau (n = 828) using their electronic mission documentation.Results 56.89% of the hoist missions were flown during the summer months, with vacation periods having a small effect on Christoph 1 only. Traumatological diagnoses clearly predominated on all three helicopters, with 75.0% on Christoph 15, 78.8% on Christoph 1, and 52.17% on Christoph Murnau. Among the traumatological indications, extremity trauma (39.29%) was the most frequent, followed by spinal injuries (10.71%), traumatic brain injuries (8.67%), and polytrauma (4.59%). Among internal medicine emergencies, collapse/syncope (5.61%) and cardiovascular arrest (3.06%) were the most common, followed by acute coronary syndromes, anaphylaxis, and hypothermia (2.55% each).Conclusions Despite the predominance of extremity injuries and syncope/collapse, where risk stratification was the primary concern and complex medical care was usually not required, there were also dynamic and complex emergency events, e.g., cardiovascular arrests, traumatic brain injuries, and anaphylaxis. Not even the Covid-19 pandemic led to a significant shift in distribution. Surprisingly, the influence of vacation periods on the frequency of operations was less pronounced even in tourism-oriented regions. For future research, other aspects need to be studied, such as the impact of severe weather on helicopter operations in the context of climate change, as well as personnel strategy (e.g., 3-person vs. 4-person crews).


Subject(s)
Brain Injuries , Multiple Trauma , Extensively Drug-Resistant Tuberculosis , Syncope , Hypothermia , Cardiovascular Diseases , COVID-19 , Spinal Cord Injuries , Wounds and Injuries
14.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3888440.v1

ABSTRACT

Objective To determine the effects of recreational physical activity mediated by technology on the body composition of six- to nine-year-old children. Childhood obesity is a public health problem associated with the development of cardiovascular disease (CVD) and which was exacerbated during the COVID-19 lockdowns, given the restrictions on going to school and participating in group games, among others.Methods A quasi-experimental intervention study included 27 schoolchildren (12 boys and 15 girls) with an average age of 6 from an educational establishment during who received three 60-minute online sessions of recreational physical activity per week for 20 weeks.Results Medical tests were carried out prior to the intervention, which found that 13.3% of girls were overweight and 40% obese, while 6.7% of boys were overweight and 41.6% obese. After the interventions, there was an average weight reduction of 1.7 kg (p = 0.16), while there were also reductions in the proportion of the participants suffering from overweight and obesity, body fat percentage (0.9 percentage points; p = 0.4) and abdominal circumference (1.01 cm; p = 0.63).Conclusion The interventions mediated by technology had a positive impact on anthropometric measurements, promoting healthy practices and physical exercise during lockdown.


Subject(s)
Obesity , COVID-19 , Cardiovascular Diseases
15.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.01.02.24300728

ABSTRACT

Measuring the mortality burden of SARS-CoV-2 in lower-income countries is difficult because death registries are incomplete and lack cause of death. We address this problem in India, which had the second-highest number of officially reported cases. We completed WHO-compliant verbal autopsy (VA) surveys on roughly 20,000 deaths drawn from a population-representative sample. SARS-CoV-2 deaths spike in June 2020, just after Indias lockdown, and in May 2021, after its second wave. During those spikes the virus is responsible for 23.3% and 35.8% of all deaths, respectively. Cardiovascular deaths also spike during the start of the pandemic. We find that the death rate rises by 81% during the pandemic, SARS-CoV-2 is responsible for 33% of these excess deaths, and cardiovascular disease for 23% of these deaths.


Subject(s)
Death , Cardiovascular Diseases
16.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.12.30.23300656

ABSTRACT

ObjectivateTo assess demographic characteristics and investigate the correlation between cardiovascular diseases and long COVID-19 patients. MethodsComprehensive details, encompassing the first authors name, publication year, sample inclusion criteria, sample size, and demographic characteristics, including age and gender of participants, were systematically extracted from all incorporated studies. Meanwhile, the analysis encompassed the assessment of the risk associated with nineteen cardiovascular outcomes. ResultsA total of 3, 201 potentially eligible studies were initially identified for consideration. Following rigorous literature screening and quality control measures, eighteen studies, encompassing 46, 083, 975 patients, met the specified criteria. In comparison to the control cohort, our investigation unveiled a heightened risk of 19 cardiovascular outcomes associated with long COVID-19. Our meta-analysis revealed a pooled OR of 1.68 (95% CI 1.55-1.81) (I2 = 69.1%, p= 0.000) for the overall risk of cardiovascular outcomes, indicating an elevated risk of cardiovascular diseases in individuals affected by long COVID-19. While the heterogeneity was relatively high, it is essential to acknowledge that all studies inherently carry an unavoidable risk of bias, irrespective of their quality rating. Moreover, there appears to be no significant publication bias based on the funnel plot, Beggs, and Eggers tests. Sensitivity analysis did not reveal substantial alterations in the overall stability of the results. ConclusionsOur meta-analysis substantiates that individuals afflicted with long COVID-19 face an elevated risk of developing cardiovascular diseases. Routine assessment of cardiac function is deemed essential for a long COVID-19 high-risk cardiovascular disease population. Timely interventions have the potential to mitigate the risk of cardiovascular diseases and associated mortality in this population. TRIAL REGISTRATION PROSPERO IdentifierCRD42023455701


Subject(s)
COVID-19 , Cardiovascular Diseases
17.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3768175.v1

ABSTRACT

Despite modern cardiovascular drugs, latest advanced treatment protocols, several decades of research like longitudinal cohort study of Framingham (ongoing cardiovascular study of residents of the city of Framingham, Massachusetts), as well as various strategies to prevent and control mortality due to myocardial infarction (popularly known as Heart Attack), global improvement against cardiovascular disease (CVD) is flat-lining. COVID-19 affects the cardiovascular system leading to myocardial damage and dysfunction mainly via (ACE-2) the Angiotensin-converting enzyme 2 receptor. The cardiovascular complications of acute COVID-19 are well described in several research studies, but the post- COVID-19 cardiovascular manifestations particularly mortality due to myocardial infarction have not yet been comprehensively evaluated or characterized in research studies. This study aimed to assess the impact of COVID-19 on annual incidence (new cases number only) of mortality due to MI in different states and union territories (UT) of India. This study is cross-sectional, quantitative, and retrospective in nature. There is an overall increase of 11.02 percent in new MI cases related mortality during the COVID-19 period. This study revealed that there is 25.80 percent increase in total number of new MI cases related mortality in 2022 in comparison to pre-COVID-19 year of 2018. The Male-Sudden death due to Myocardial Infarction increased during COVID-19 year 2022 by 26.71 percent in comparison to 2018 pre- COVID-19 year. Percent wise top 3 states reporting sudden death due to MI in males include Maharashtra, Kerala and Gujarat. This study revealed that there is 26.71 percent increase in total number of new MI cases related mortality in males in 2022 in comparison to pre-COVID-19 year of 2018. There is an overall increase of 11.24 percent in new MI cases related mortality in males during the COVID-19 period of this study. The Sudden death due to Myocardial Infarction in female increased by 20.17 percent during COVID-19 year 2022 in comparison to 2018 pre- COVID-19 year.


Subject(s)
Myocardial Infarction , COVID-19 , Cardiovascular Diseases , Death, Sudden , Cardiomyopathies
18.
preprints.org; 2023.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202310.0701.v2

ABSTRACT

Background: COVID-19 was initially identified as a respiratory system disorder, but it has been discovered to interact with and influence the cardiovascular system. COVID-19-associated cardiovascular (CV) complications are common, resulting in high acute phase mortality and a large number of morbidities in the chronic phase, thus severely impacting patients' quality of life and health outcomes. Nevertheless, clinical, cellular, and molecular biological factors underlying the pathophysiology of cardiovascular complications associated with COVID-19 are poorly understood. Objective: This review investigates putative underlying clinical factors as well as cellular and molecular biological mechanisms by which COVID-19 leads to acute CV complications, including state-of-the-art genomic sequencing-based findings, assessing the long-term CV consequences of COVID-19, and aiming to shed light on developing strategies for differential diagnosis, risk prognostic stratification, prevention, and clinical management of CV sequlea in COVID-19 patients. Methods: For this purpose, a through review of literature and published data was carried out from first report of COVID-19 till October 2023 to find out a comprehensive account of clinical, cellular and molecular genetic factors underlying COVID-19-associated cardiovascular diseases. Results: We found that the relationship between COVID-19 and CV risk is complex and multifaceted. In addition to acute COVID-19 detertriuos effects, COVID-19 survivors may experience long-term CV effects. We provide a detailed account of the involvement of a large number of genomic alterations, microRNAs, and novel viral as well as host proteins in CVDs associated with COVID-19, which has helped identify some novel drug targets to treat COVID-19-related cardiovascular complications. Conclusions: The relationship between COVID-19 and CV risk is complex and multifaceted. While COVID-19 primarily affects the respiratory system, it can also significantly affect CV health. as compared to classical cardiovascular diseases, there are new clinical, cellular and molecular biological factors in CVDs related to COVID-19, that need specific diagnostic assays, prognostic stratification and treatment modules. Therefore, specail care is must taken to treat cardiovascular diseases associated with COVID-19.


Subject(s)
Respiratory System Abnormalities , COVID-19 , Cardiovascular Diseases
19.
preprints.org; 2023.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202312.0791.v1

ABSTRACT

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a frequent, debilitating and still enigmatic disease. There is a broad overlap in the symptomatology of ME/CFS and the Post-COVID Syndrome (PCS). A fraction of the PCS patients develops the full clinical picture of ME/CFS. New observations in microvessels and blood from patients suffering from PCS have appeared and include microclots and malformed pathological blood cells. Capillary blood flow is impaired not only by pathological blood components but also by prothrombotic changes in the vascular wall, endothelial dysfunction, and expression of adhesion molecules in the capillaries. These disturbances can finally cause a low capillary flow and even capillary stasis. A low cardiac stroke volume due to hypovolemia and the inability of the capacitance vessels to adequately constrict to deliver the necessary cardiac preload generate an unfavorable low precapillary perfusion pressure. Furthermore, a predominance of vasoconstrictor over vasodilator influences exists, in which sympathetic hyperactivity and endothelial dysfunction play a strong role, causing constriction of resistance vessels and of precapillary sphincters which leads to a fall in capillary pressure behind the sphincters. The interaction of these two precapillary cardiovascular mechanisms causing a low capillary perfusion pressure is hemodynamically highly unfavorable in the presence of a primary capillary stasis already caused by the pathological blood components and their interaction with the capillary wall, to severely impair organ perfusion. The detrimental coincidence of the microcirculatory with the precapillary cardiovascular disturbances may constitute the key disturbance of the Post-COVID-19 syndrome and finally lead to ME/CFS in pre-disposed patients because the interaction causes a particular kind of perfusion disturbance - capillary ischemia-reperfusion - which has a high potential of causing mitochondrial dysfunction by inducing sodium- and calcium-overload in skeletal muscles. The latter in turns worsens the vascular situation by the generation of reactive oxygen species to close a vicious cycle from which the patient can hardly escape.


Subject(s)
Stroke , Sphincter of Oddi Dysfunction , Ischemia , Hypovolemia , COVID-19 , Hyperkinesis , Cardiovascular Diseases , Fatigue Syndrome, Chronic , Mitochondrial Diseases
20.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.12.08.23299713

ABSTRACT

Background: Earlier death among people in socioeconomically deprived circumstances has been found internationally and for various causes of death, resulting in a considerable life expectancy gap between socioeconomic groups. This study examines how age- and cause-specific mortality contributions to the socioeconomic gap in life expectancy have changed in Germany over time. Methods: Official German population and cause-of-death statistics from 2003 to 2021 were linked to the district-level German Index of Socioeconomic Deprivation. Life-table and decomposition methods were applied to calculate life expectancy by deprivation quintile and decompose the life expectancy gap (∆LE) between the most and least deprived quintiles into age- and cause-specific mortality contributions. Findings: From 2003 to 2019, the ∆LE between the most and least deprived quintiles of districts increased from 1.1 to 1.8 years among women and from 3.0 to 3.1 years among men. Thereafter, in the COVID-19 pandemic, it increased more rapidly to 2.2 and 3.5 years respectively in 2021. The causes of death contributing most to the ∆LE were cardiovascular diseases (CVD) and cancer, with declining contributions of CVD deaths at age 70 and above and increasing contributions of cancer deaths at ages 40-74 over time. COVID-19 mortality at ages 45+ was the strongest contributor to the increase in ∆LE after 2019. Interpretation To reduce the socioeconomic gap in life expectancy, effective efforts are needed to prevent early deaths from CVD and cancer in deprived populations, with cancer prevention and control becoming an increasingly important field of action in this respect.


Subject(s)
Death , COVID-19 , Cardiovascular Diseases , Neoplasms
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